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Presentation comparison
EmergencyCovers delirium, acute confusion, toxic-metabolic encephalopathy, and post-ictal confusion.
1 of 7 diagnoses compared
| CriteriaComparison detail | Substance withdrawalEmergency |
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Inattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines.
Clinical reference — not validated decision support. Review before use.
| Substance intoxicationEmergencyNot selected |
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| Post-ictal stateEmergencyNot selected |
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| Dementia with superimposed deliriumEmergencyNot selected |
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| Wernicke encephalopathyEmergencyNot selected |
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| Hepatic encephalopathyEmergencyNot selected |
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| Why it fits | Time course, tremor, sweats, tachycardia, hypertension, anxiety, seizures | Acute change, fluctuating course, inattention | Time-link to use, toxidrome clues (pupils, RR, nystagmus, tremor) | Witnessed or suspected seizure, stereotyped event, post-event confusion | Known cognitive disorder with sudden worsening | Heavy alcohol use, malnutrition, triad of confusion/ataxia/eye signs may be incomplete | Liver disease, asterixis, GI bleed, constipation, infection |
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| What argues against | Applies to the whole presentationPrimary psychosis, dementia | ||||||
| Must-not-miss | Alcohol/benzo withdrawal seizures, delirium tremens, severe GHB withdrawal | Sepsis, hypoxia, hypoglycaemia, stroke, intracranial bleed, alcohol/benzo withdrawal, urinary retention, faecal impaction | Opioid respiratory depression, head injury | ||||
| Bedside question | Applies to the whole presentationInattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines. | ||||||
| Immediate action | Applies to the whole presentationDo vitals, BGL, sats, attention testing, collateral, and medication/substance review early Use 4AT in most adult settings, and ICU tools where appropriate | ||||||
| Investigations | Applies to the whole presentationBlood glucose, Vitals and oxygen saturation | ||||||
| Mimics / overlap | Applies to the whole presentationPrimary psychosis, dementia, severe depression, catatonia | ||||||
Scroll horizontally to review more candidate differentials. Clinical reference — not validated decision support. Review before use.
Primary psychosis, dementia
Inattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines.
Do vitals, BGL, sats, attention testing, collateral, and medication/substance review early Use 4AT in most adult settings, and ICU tools where appropriate
Blood glucose, Vitals and oxygen saturation
Primary psychosis, dementia, severe depression, catatonia
Time course, tremor, sweats, tachycardia, hypertension, anxiety, seizures
Alcohol/benzo withdrawal seizures, delirium tremens, severe GHB withdrawal
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Last updated: Pending review
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Create a concise comparison summary for documentation or handoff.
Source pending review
v10 | Local content only
Last updated: Pending review
| Non-convulsive status epilepticus, head injury |
| Infection, retention, constipation, dehydration, medication toxicity, pain |
| Permanent cognitive injury, Korsakoff syndrome |
| GI bleed, sepsis, over-sedation, impending coma |